Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study
ObjectivesWe prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determ...
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| creator | Gómez-Marcos, Manuel Ángel Recio-Rodríguez, José Ignacio Patino-Alonso, María Carmen Agudo-Conde, Cristina Rodríguez-Sanchez, Emiliano Maderuelo-Fernandez, Jose Angel Gómez-Sánchez, Leticia Gomez-Sanchez, Marta García-Ortiz, Luís |
| description | ObjectivesWe prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease.Setting2 primary care centres in Salamanca, Spain.ParticipantsWe performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years.Primary and secondary outcome measuresMeasurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices.ResultsIn year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2.ConclusionsThis prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group.Trial registration numberNCT01065155; Results. |
| doi_str_mv | 10.1136/bmjopen-2015-010400 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4893862</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1793909112</sourcerecordid><originalsourceid>FETCH-LOGICAL-b3170-b88e8ce3452e0f03e29d0c532c051a2b7983b7607397d411df80a2f88f0a2efc3</originalsourceid><addsrcrecordid>eNqNUk1v1DAQjRCIVqW_AAlZ4sIlxR_JxuGA1I8FKq3UA-VsTZzJrldJHGwnaG9c-DX8K34JjrJUhRO-zNjz3tOM5yXJS0YvGBOrt1W3twP2KacsTymjGaVPklNOsyxd0Tx_-ig_Sc6939N4srzMc_48OeEFz9lKZqfJz_Vk2zEY2xPbkABui4FYt4We1NDBFgn0NdkBdrY-9NAZTQZw0GFA54md0JHs1_cfB4R4NX0sBoN98OSbCbv4oB2Cxzpmfmxj3aE3PkCv8R0JOySbu5v05vbyan2__kwGZ_2AOpgJia08ugnmzqAlPoz14UXyrIHW4_kxniVfPqzvrz-lm7uPt9eXm7QSrKBpJSVKjSLLOdKGCuRlTXUuuKY5A14VpRRVsaKFKIs6Y6xuJAXeSNnEgI0WZ8n7RXcYqw5rHedx0KrBmQ7cQVkw6u9Kb3ZqayeVyVLIFY8Cb44Czn4d0QfVGa-xbaFHO3rFilKUtGRshr7-B7q3o4sjLygZ98RnlFhQOv6Qd9g8NMOomv2gjn5Qsx_U4ofIevV4jgfOn-1HwMUCiOz_UvwNJHXFtw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1793825122</pqid></control><display><type>article</type><title>Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study</title><source>BMJ Open Access Journals</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Gómez-Marcos, Manuel Ángel ; Recio-Rodríguez, José Ignacio ; Patino-Alonso, María Carmen ; Agudo-Conde, Cristina ; Rodríguez-Sanchez, Emiliano ; Maderuelo-Fernandez, Jose Angel ; Gómez-Sánchez, Leticia ; Gomez-Sanchez, Marta ; García-Ortiz, Luís</creator><creatorcontrib>Gómez-Marcos, Manuel Ángel ; Recio-Rodríguez, José Ignacio ; Patino-Alonso, María Carmen ; Agudo-Conde, Cristina ; Rodríguez-Sanchez, Emiliano ; Maderuelo-Fernandez, Jose Angel ; Gómez-Sánchez, Leticia ; Gomez-Sanchez, Marta ; García-Ortiz, Luís ; LOD-DIABETES Group ; LOD-DIABETES Group</creatorcontrib><description>ObjectivesWe prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease.Setting2 primary care centres in Salamanca, Spain.ParticipantsWe performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years.Primary and secondary outcome measuresMeasurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices.ResultsIn year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2.ConclusionsThis prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group.Trial registration numberNCT01065155; Results.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2015-010400</identifier><identifier>PMID: 27251684</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Aged ; Ankle Brachial Index ; Blood Pressure ; Blood Pressure Determination ; C-Reactive Protein - metabolism ; Cardiology ; Carotid Intima-Media Thickness ; Creatinine ; Diabetes ; Diabetes and Endocrinology ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - physiopathology ; Female ; Glucose ; Hemodynamics ; Humans ; Hypertension ; Insulin Resistance ; Kidney - physiopathology ; Male ; Metabolic syndrome ; Metabolic Syndrome - complications ; Metabolic Syndrome - physiopathology ; Middle Aged ; Prospective Studies ; Pulse Wave Analysis - methods ; Risk Factors ; Software ; Spain ; Ultrasonic imaging ; Values ; Vascular Diseases - diagnostic imaging ; Vascular Diseases - physiopathology ; Vascular Stiffness ; Veins & arteries</subject><ispartof>BMJ open, 2016-06, Vol.6 (6), p.e010400-e010400</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3170-b88e8ce3452e0f03e29d0c532c051a2b7983b7607397d411df80a2f88f0a2efc3</citedby><cites>FETCH-LOGICAL-b3170-b88e8ce3452e0f03e29d0c532c051a2b7983b7607397d411df80a2f88f0a2efc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/6/6/e010400.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/6/6/e010400.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27548,27549,27923,27924,53790,53792,77372,77403</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27251684$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gómez-Marcos, Manuel Ángel</creatorcontrib><creatorcontrib>Recio-Rodríguez, José Ignacio</creatorcontrib><creatorcontrib>Patino-Alonso, María Carmen</creatorcontrib><creatorcontrib>Agudo-Conde, Cristina</creatorcontrib><creatorcontrib>Rodríguez-Sanchez, Emiliano</creatorcontrib><creatorcontrib>Maderuelo-Fernandez, Jose Angel</creatorcontrib><creatorcontrib>Gómez-Sánchez, Leticia</creatorcontrib><creatorcontrib>Gomez-Sanchez, Marta</creatorcontrib><creatorcontrib>García-Ortiz, Luís</creatorcontrib><creatorcontrib>LOD-DIABETES Group</creatorcontrib><creatorcontrib>LOD-DIABETES Group</creatorcontrib><title>Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectivesWe prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease.Setting2 primary care centres in Salamanca, Spain.ParticipantsWe performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years.Primary and secondary outcome measuresMeasurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices.ResultsIn year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2.ConclusionsThis prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group.Trial registration numberNCT01065155; Results.</description><subject>Aged</subject><subject>Ankle Brachial Index</subject><subject>Blood Pressure</subject><subject>Blood Pressure Determination</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cardiology</subject><subject>Carotid Intima-Media Thickness</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Diabetes and Endocrinology</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Female</subject><subject>Glucose</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Insulin Resistance</subject><subject>Kidney - physiopathology</subject><subject>Male</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - complications</subject><subject>Metabolic Syndrome - physiopathology</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Pulse Wave Analysis - methods</subject><subject>Risk Factors</subject><subject>Software</subject><subject>Spain</subject><subject>Ultrasonic imaging</subject><subject>Values</subject><subject>Vascular Diseases - diagnostic imaging</subject><subject>Vascular Diseases - physiopathology</subject><subject>Vascular Stiffness</subject><subject>Veins & arteries</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNUk1v1DAQjRCIVqW_AAlZ4sIlxR_JxuGA1I8FKq3UA-VsTZzJrldJHGwnaG9c-DX8K34JjrJUhRO-zNjz3tOM5yXJS0YvGBOrt1W3twP2KacsTymjGaVPklNOsyxd0Tx_-ig_Sc6939N4srzMc_48OeEFz9lKZqfJz_Vk2zEY2xPbkABui4FYt4We1NDBFgn0NdkBdrY-9NAZTQZw0GFA54md0JHs1_cfB4R4NX0sBoN98OSbCbv4oB2Cxzpmfmxj3aE3PkCv8R0JOySbu5v05vbyan2__kwGZ_2AOpgJia08ugnmzqAlPoz14UXyrIHW4_kxniVfPqzvrz-lm7uPt9eXm7QSrKBpJSVKjSLLOdKGCuRlTXUuuKY5A14VpRRVsaKFKIs6Y6xuJAXeSNnEgI0WZ8n7RXcYqw5rHedx0KrBmQ7cQVkw6u9Kb3ZqayeVyVLIFY8Cb44Czn4d0QfVGa-xbaFHO3rFilKUtGRshr7-B7q3o4sjLygZ98RnlFhQOv6Qd9g8NMOomv2gjn5Qsx_U4ofIevV4jgfOn-1HwMUCiOz_UvwNJHXFtw</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Gómez-Marcos, Manuel Ángel</creator><creator>Recio-Rodríguez, José Ignacio</creator><creator>Patino-Alonso, María Carmen</creator><creator>Agudo-Conde, Cristina</creator><creator>Rodríguez-Sanchez, Emiliano</creator><creator>Maderuelo-Fernandez, Jose Angel</creator><creator>Gómez-Sánchez, Leticia</creator><creator>Gomez-Sanchez, Marta</creator><creator>García-Ortiz, Luís</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160601</creationdate><title>Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study</title><author>Gómez-Marcos, Manuel Ángel ; Recio-Rodríguez, José Ignacio ; Patino-Alonso, María Carmen ; Agudo-Conde, Cristina ; Rodríguez-Sanchez, Emiliano ; Maderuelo-Fernandez, Jose Angel ; Gómez-Sánchez, Leticia ; Gomez-Sanchez, Marta ; García-Ortiz, Luís</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b3170-b88e8ce3452e0f03e29d0c532c051a2b7983b7607397d411df80a2f88f0a2efc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Ankle Brachial Index</topic><topic>Blood Pressure</topic><topic>Blood Pressure Determination</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cardiology</topic><topic>Carotid Intima-Media Thickness</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Diabetes and Endocrinology</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Female</topic><topic>Glucose</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Insulin Resistance</topic><topic>Kidney - physiopathology</topic><topic>Male</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - complications</topic><topic>Metabolic Syndrome - physiopathology</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Pulse Wave Analysis - methods</topic><topic>Risk Factors</topic><topic>Software</topic><topic>Spain</topic><topic>Ultrasonic imaging</topic><topic>Values</topic><topic>Vascular Diseases - diagnostic imaging</topic><topic>Vascular Diseases - physiopathology</topic><topic>Vascular Stiffness</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gómez-Marcos, Manuel Ángel</creatorcontrib><creatorcontrib>Recio-Rodríguez, José Ignacio</creatorcontrib><creatorcontrib>Patino-Alonso, María Carmen</creatorcontrib><creatorcontrib>Agudo-Conde, Cristina</creatorcontrib><creatorcontrib>Rodríguez-Sanchez, Emiliano</creatorcontrib><creatorcontrib>Maderuelo-Fernandez, Jose Angel</creatorcontrib><creatorcontrib>Gómez-Sánchez, Leticia</creatorcontrib><creatorcontrib>Gomez-Sanchez, Marta</creatorcontrib><creatorcontrib>García-Ortiz, Luís</creatorcontrib><creatorcontrib>LOD-DIABETES Group</creatorcontrib><creatorcontrib>LOD-DIABETES Group</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gómez-Marcos, Manuel Ángel</au><au>Recio-Rodríguez, José Ignacio</au><au>Patino-Alonso, María Carmen</au><au>Agudo-Conde, Cristina</au><au>Rodríguez-Sanchez, Emiliano</au><au>Maderuelo-Fernandez, Jose Angel</au><au>Gómez-Sánchez, Leticia</au><au>Gomez-Sanchez, Marta</au><au>García-Ortiz, Luís</au><aucorp>LOD-DIABETES Group</aucorp><aucorp>LOD-DIABETES Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>6</volume><issue>6</issue><spage>e010400</spage><epage>e010400</epage><pages>e010400-e010400</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectivesWe prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease.Setting2 primary care centres in Salamanca, Spain.ParticipantsWe performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years.Primary and secondary outcome measuresMeasurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices.ResultsIn year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2.ConclusionsThis prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group.Trial registration numberNCT01065155; Results.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>27251684</pmid><doi>10.1136/bmjopen-2015-010400</doi><oa>free_for_read</oa></addata></record> |
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| source | BMJ Open Access Journals; MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Ankle Brachial Index Blood Pressure Blood Pressure Determination C-Reactive Protein - metabolism Cardiology Carotid Intima-Media Thickness Creatinine Diabetes Diabetes and Endocrinology Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - physiopathology Female Glucose Hemodynamics Humans Hypertension Insulin Resistance Kidney - physiopathology Male Metabolic syndrome Metabolic Syndrome - complications Metabolic Syndrome - physiopathology Middle Aged Prospective Studies Pulse Wave Analysis - methods Risk Factors Software Spain Ultrasonic imaging Values Vascular Diseases - diagnostic imaging Vascular Diseases - physiopathology Vascular Stiffness Veins & arteries |
| title | Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T09%3A04%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evolution%20of%20target%20organ%20damage%20and%20haemodynamic%20parameters%20over%204%E2%80%85years%20in%20patients%20with%20increased%20insulin%20resistance:%20the%20LOD-DIABETES%20prospective%20observational%20study&rft.jtitle=BMJ%20open&rft.au=G%C3%B3mez-Marcos,%20Manuel%20%C3%81ngel&rft.aucorp=LOD-DIABETES%20Group&rft.date=2016-06-01&rft.volume=6&rft.issue=6&rft.spage=e010400&rft.epage=e010400&rft.pages=e010400-e010400&rft.issn=2044-6055&rft.eissn=2044-6055&rft_id=info:doi/10.1136/bmjopen-2015-010400&rft_dat=%3Cproquest_pubme%3E1793909112%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1793825122&rft_id=info:pmid/27251684&rfr_iscdi=true |